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A meta-analysis to determine the effect of preinjury antiplatelet agents on mortality in patients with blunt head trauma.
MedLine Citation:
PMID:  22900511     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Introduction. Anticoagulation abnormalities have been recognized for several decades as potential risk factors for increasing the risk of traumatic intracranial haemorrhage in patients with blunt head trauma. The potential increased risk of death as a consequence has not been fully evaluated. The aim of the study was to perform a meta-analysis in order to evaluate based upon the current level of evidence whether the use of pre-injury aspirin or clopidogrel increases the risk of mortality in patients with blunt head trauma. Methods. The databases Medline and EMBASE were searched via the Ovid interface. The Medline database was also searched using the PubMed interface. Case control studies or nested case control studies were identified comparing mortality rates on patients with blunt head trauma in patients on aspirin or clopidogrel against patients not on antiplatelet agents. Results. Five studies in total were identified as suitable for the meta-analysis. Four of these studies were suitable for the aspirin meta-analysis and four for the clopidogrel meta-analysis. The common odds ratio for the aspirin meta-analysis using the Random Effects model was found to be 2.435 (95% CI: 0.637-9.314). Significant heterogeneity was present I(2) = 79.521. The common odds ratio for the clopidogrel meta-analysis using the Random Effects model was found to be 1.554 (95% CI: 0.320-7.536). Significant heterogeneity was present I(2) = 69.090. Conclusions. In summary, this meta-analysis showed a slight increased risk of death in patients with blunt head trauma who were taking pre-injury antiplatelet agents although the results did not reach statistical significance. In view of the small number of low level studies from which this meta-analysis is based, further work is required in this area.
Authors:
John Stephen Batchelor; Alan Grayson
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-17
Journal Detail:
Title:  British journal of neurosurgery     Volume:  -     ISSN:  1360-046X     ISO Abbreviation:  Br J Neurosurg     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8800054     Medline TA:  Br J Neurosurg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Emergency Medicine, Manchester Royal Infirmary Foundation Trust , Oxford Road, Manchester , England.
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